Challenges and Forces Driving Adoption of Health Information Technology and Electronic Healthcare Records

Michael D. Paquin, FHIMSS

www.mdpgrp.com

In this segment on Electronic Healthcare records, being sponsored by Physicians Office Resource, we will look at:

The Stimulus Bill, the Physician, and the "Free" EHR?

Learn How to Qualify For Payments of $44,000 - $64,000 Per Physician.

The Stimulus Bill is a golden opportunity for physicians to get paid to realize the full benefits of a modern EHR system.  The American Recovery & Reinvestment Act was signed into law on February 17, 2009.  The health IT component of the Bill, the HITECH Act, appropriates $19.2 billion dollars to encourage the adoption of electronic health records.  The Stimulus Bill should help provide most physicians in the United States with an electronic health record system at ZERO net cost to the physician.  For some, the incentive payment is enough to cover the cost of a top-of- the line EHR system.  The opportunity presented by the bill to the American Physician is substantial.  

Stimulus Bill – Physician Incentive Overview of HITECH

Reading the 267 pages of the HITECH section of the bill can by tedious and time consuming.   As such, we’ve included some of the key points relevant to the EHR incentive payment for physicians.   If you have any questions regarding the actual language, please contact us and we will do our best to help. 

Basically, the Bill provides that qualified physicians who utilize a certified electronic health record in a “meaningful” way will receive incentive payments through additional reimbursements via either Medicare or Medicaid, depending upon the individual physician’s payor mix. 

• Starting in 2011, “meaningful” EHR users can earn $44,000 under the Medicare plan and $64,000 under the Medicaid plan over 5 years.
• Early adopters benefits most as about 70% of the payments comes in the first two years.
• Those engaged in PQRI and electronic prescribing can earn an additional $6,000 - $8,000 per year beginning immediately.
• Physicians that do not adopt an EHR by 2015 will be penalized though % decreases in Medicare reimbursements rates.

What does the Stimulus Bill - HITECH mean for your medical practice?

If you currently utilize a EHR, congratulations as you are ahead of the curve.  You may be on track to receive full benefit of the stimulus package when the payments begin.  However, to be eligible to receive full benefits you need to demonstrate “meaningful” use of a certified EHR system.   Purchase and implementation are not enough.  “Meaningful” is not currently defined, however the initial legislation looks like this: 

• Using certified EHR technology that includes electronic prescribing; and
• Using EHR technology that allows electronic exchange of health information.
• Eligible professionals must submit information for the period on the clinical quality measures and other measures selected by the secretary of the Department of Health and Human Services (HHS).

What constitutes a “certified” EHR is to be determined by the Sec. of HHS.  However, many believe that CCHIT will be instrumental in the certification process.   If your current EHR has received CCHIT certification, then you should once again be ahead of the curve.

Stay in contact with The MDP Group for more details about the definition of “meaningful” use and what qualifies as a certified product.  If your use of the system is lacking, the vendors should be able to offer additional training and /or programs that can help increase the proficiency of your EHR utilization.

If you and your practice do not currently utilize a reputable EHR there are some things to consider.  While it is true that the stimulus payments are not scheduled to begin until 2011, the window for qualifying to receive the maximum payments will close quickly for several reasons.  

First of all, to qualify for the incentive payments you must demonstrate “meaningful” use of a certified EHR.  Purchase and implementation are not enough.  The transition to a new EHR system can be a timely process when you include the following steps:  evaluate your workflows, develop your selection criteria, select a vendor, develop your implementation plan, install your EHR, connect to other providers and have your physicians fully functionally.  Typically, the time requirements of the steps increase in proportion to the size of the group.  If you haven’t started the process, 2011 is a lot closer than many would like. 

Next, if you do not act before the “masses” you may have a difficult time getting on any vendor’s implementation schedule in the near future.  Only 20% - 30% of the market has implemented an EHR system.  The Congressional Budget Office predicts 90% of physicians will be using an EHR in a matter of just a few years.  That means 60% to 70% of the market is going to try to get implemented in the next several years.  Even prior to the Stimulus Act, some vendors had waiting lists up to 6 months.  Those physician’s who wait, may have little chance of qualifying as an early adopter.

Furthermore, opportunities are already in place and physicians might want to take advantage of them now.  Besides the many cost saving opportunities and positive ROI traits inherent in an EHR, CMS has current incentive programs in place (PQRI and electronic prescribing) that could generate $6,000 - $8,000 / physician / year.

Possible ROI example using the Stimulus Package: